Beneficial gut bacteria. Gut microbiota: the importance of bacteria in the formation of immunity

When we think about our health, we share our bodies with our gut bacteria. In fact, we can say that many functions of our body depend on the bacteria that are in our intestines. These bacteria can make us thin or fat, healthy or sick, happy or depressed. Science is just beginning to understand how the gut microflora affects our lives. In this article, we'll take a look at the known information about our gut bacteria, including how they shape our bodies and our minds.

Intestinal microflora - what is it?

The large communities of microbes (bacteria, fungi, viruses) living in our gut are called the gut microflora. Our intestines are inhabited by 10 13 - 10 14 (up to one hundred trillion) bacteria. In fact, less than half of the cells in the human body belong to the body. More than half of the cells in our body are bacteria that inhabit the intestines and skin.

Previously, it was thought that there were ten times more microbes in the body than cells in the body, but new calculations show a ratio close to 1:1. The intestine of an adult contains 0.2 - 1 kg of bacteria.

Gut bacteria play many beneficial roles in our bodies.:

• Helps you get more energy from food
• Ensures the production of important vitamins such as B and K
• Strengthen the intestinal barrier
• Improve work immune system
• Protect the intestines from harmful and opportunistic microorganisms
• Contribute to the development process bile acids
• Decompose toxins and carcinogens
• Are necessary condition for the normal functioning of organs, especially the intestines and brain

An unbalanced microflora makes us more susceptible to infections, immune disorders and inflammation.

Thus, improving the gut microflora is a promising approach to combat a range of common diseases.

The composition of the intestinal microflora

Science estimates that our gut is home to over 2,000 species of bacteria. Most bacteria in the gut (80-90%) belong to 2 groups: Firmicutes and Bacteroides.

The small intestine has relatively short food transit times and typically contains high levels of acids, oxygen, and antimicrobial agents. All this limits the growth of bacteria. Only fast-growing bacteria that are resistant to oxygen and are able to attach strongly to the intestinal wall are able to survive in the small intestine.

In contrast to this, colon has a large and diverse community of bacteria. For their life, they use complex carbohydrates that are not digested in the small intestine.

Development and aging of the intestinal microflora

Previously, science and medicine believed that the intestinal microflora is formed after birth. However, some recent research suggests that the placenta may also have its own unique microflora. Thus, humans can be colonized by bacteria while still in the womb.

In a normal birth, a newborn's intestines receive microbes from both the mother and environment. Upon reaching the age of one, each person receives a unique, peculiar only to him, bacterial profile. [And] By the age of 3 years, the composition of the intestinal microflora of a child becomes similar to the microflora of an adult. [AND]

However, in response to the activity of hormones during puberty, the intestinal microflora changes once again. As a result, there are differences between men and women. To a greater extent, the microflora in boys changes under the influence of the hormone testosterone, and in girls, bacteria gain the ability to change their quantitative composition when exposed to menstrual cycles. [AND]

In adulthood, the composition of the intestinal microflora is relatively stable. However, it can still be altered by life events such as antibiotics, stress, physical inactivity, obesity and, to a large extent, diet. [AND]

In people over 65 years of age, the microbial community is shifting towards an increase in numbers. Bacteroids. In general, bacterial metabolic processes such as short chain fatty acid (SCFA) production are reduced while protein breakdown is increased. [AND]

Microflora opens an exciting new chapter in science

Science is just beginning to understand the many roles that gut microbes play in our bodies. Research into gut bacteria is growing exponentially, and most of this research is very recent.

However, there are still many questions that remain unanswered. However, we can expect many exciting new breakthroughs in the coming years.

How bacteria in your gut affect your health

Gut microflora produces essential vitamins

Gut bacteria produce vitamins, some of which we cannot produce ourselves [R]:

• Vitamin B-12
• Folic Acid / Vitamin B-9
• Vitamin K
• Riboflavin / Vitamin B-2
• Biotin / Vitamin B-7
• A nicotinic acid/ Vitamin B-3
• Pantothenic Acid / Vitamin B-5
• Pyridoxine / Vitamin B-6
• Thiamine / Vitamin B-1

Gut microflora produces fatty acids

Intestinal bacteria produce short chain fatty acids(SCFAs). These acids include butyrate, propionate, and acetate. [AND]

These SCFAs (Short Chain Fatty Acids) have many important functions in our body.:

• Provides approximately 10% of the daily caloric value in the digestion of food. [AND]
• Activate AMF and stimulate weight loss [R]
• Propionate reduces, lowers blood cholesterol levels, and also increases the feeling of satiety [R]
• Acetate reduces appetite [R]
• Butyrate reduces inflammation and fights cancer[AND]
• Acetate and propionate increase the amount of circulating Treg(regulatory T cells), which are able to reduce excessive immune reactions[AND]

Diets with more fiber and less meat, for example, vegetarian or, lead to an increase in the number of SCFAs (short chain fatty acids). [AND]

Gut microflora changes our brain

Gut bacteria communicate with our brain, they are able to influence our behavior and mental abilities. [And] This interaction works in two ways. Gut microbes and the brain influence each other, and science calls the connection the “gut-brain axis.”

How do the gut and brain communicate?

• Through the vagus nerve and autonomic nervous system[AND]
• Bacteria produce serotonin, GABA, acetylcholine, dopamine, and norepinephrine in the gut. Through the blood, these substances can enter the brain. [AND]
• Short-chain fatty acids (SCFAs) are produced by the gut microflora, which provide energy for nerve and glial cells in the brain. [AND]
• Through immune cells and inflammatory cytokines. [AND]

Gut bacteria can improve or worsen mood and behavior

When the gut microflora is disturbed as a result of infection or inflammation, it can impair our mental health. People with inflammatory bowel disease often show signs or anxiety. [AND]

In another controlled study with 40 healthy adults, probiotics were able to help reduce negative thoughts manifested in the form of a sad mood. [AND]

A study involving 710 people showed that fermented foods(high in probiotics) may help reduce people's anxiety. [AND]

Interestingly, when rats are given gut microflora from people with depression, the rats quickly develop depression. [And] On the other hand, “good” bacteria, such as Lacto- and Bifidobacteria, reduce anxiety and depressive syndromes in the same rats. [And] As it turned out, these bacteria increase the content of tryptophan in the blood of rats. Tryptophan is necessary for the synthesis of serotonin (the so-called "hormone of happiness"). [AND]

Interestingly, sterile mice (without gut bacteria) showed less anxiety. They were found to have more serotonin in the brain (hippocampus). Such calm behavior could be changed by bacterial colonization in their intestines, but such exposure through microbes only worked in young mice. This shows that the gut microflora plays an important role in brain development in children. [AND]

A study of over 1 million people found that treating patients with one type of antibiotic increases the risk of depression. The risk of developing depression or anxiety increased with repeated use of antibiotics and with an increase in the number of concurrent use of different antibiotics. [AND]

Gut microflora can improve and impair brain function

In one study, negative changes in the gut microflora were shown to lead to poor brain function in 35 adults and 89 children. [AND]

In another study, sterile mice and mice with bacterial infections were found to have memory problems. But adding probiotics to their diet for 7 days before and during infectious diseases led to a decrease in brain disorders. [AND]

Long-term use of antibiotics in mice reduced the production of new nerve cells in the brain (hippocampus). But this disruption was reduced or completely abolished with supplemental probiotics or increased physical activity. [AND]

Food can also affect cognitive function by altering the gut microflora. western diet(high content of saturated fats and sugar) contributes to a decrease in the intestines of Bacteroidetes in mice and an increase in Fimicuts (Firmicutes) together with Proteobacteria. Such changes are associated with the development of brain dysfunction. [AND]

When gut bacteria were transferred from mice fed a Western diet to other mice, mice receiving this microflora showed increased anxiety and impaired learning and memory. [AND]

On the other hand, “good bacteria” help improve brain function. Several types of probiotics have been shown in studies to improve cognitive performance in experimental animals. [AND]

Microflora can make you more or less susceptible to stress

Your gut bacteria determines the way you react to stress. Our microflora programs the hypothalamic-pituitary-adrenal axis at the very beginning of our lives. This, in turn, determines our response to stress later in life. [AND]

Gut bacteria can contribute to the development post-traumatic stress disorder(PTSD). Animal studies have shown that an imbalance in the gut microflora (dysbacteriosis) makes the behavior of these animals more susceptible to developing PTMS after a traumatic event. [AND]

Neutered mice exhibit exaggerated responses to stress (their hypothalamic-pituitary-adrenal axis is in a hyperactive state). Such animals show more low rates BNDF- a factor that is necessary for the survival of nerve cells. But if these mice received Bifidobacteria early in their life, the hypothalamic-pituitary-adrenal axis was restored to its normal state. [AND]

In a study involving 581 students, it was demonstrated that taking probiotics based on bifidobacteria led to a decrease in diarrhea (or intestinal discomfort) and a decrease in the incidence of colds (flu) during stressful conditions (exams). [AND]

Similarly, bifidobacteria B.longum reduced stress levels (measured cortisol) and anxiety in 22 healthy volunteers. [AND]

It is known that during pregnancy, the maternal immune system is shifted towards the Th2 immune response (anti-inflammatory). This change in immunity causes a shift in immune function in the direction of the Th2 response in the child. [AND] However, during the first weeks and months of life, gut bacteria help infants gradually increase the activity of the Th1 inflammatory immune response and restore the Th1/Th2 balance. [AND]

In infants born as a result caesarean section, Th1 immunity is activated with a delay. The decrease in the rate of formation of the Th1 immune response is due to the altered intestinal microflora. [AND]

Gut microflora protects against infections

One of the main benefits of the gut microflora is that it protects us from harmful microbes. [AND]

Intestinal bacteria protect us from infection by[AND]:

• Its struggle for nutrients with harmful bacteria
• Production of by-products that interfere with growth or activity dangerous bacteria
• Maintaining the intestinal mucosal barrier
• Stimulation of our innate and adaptive immunity

The stable state of the intestinal microflora also prevents the overgrowth of opportunistic microbes. For example, lactobacilli are very important in preventing strong bacterial growth. candida albicans . [AND]

Antibiotics often alter the intestinal flora, thereby reducing resistance against harmful bacteria. [AND]

Microflora suppresses inflammation

Gut bacteria can increase the production of th17 cells and pro-inflammatory cytokines (IL-6, IL-23, IL-1b). Or the gut microbiota may contribute to the production of circulating immune cells T-reg, thus reducing inflammation. [And] Both of these developmental pathways depend on the microflora in your gut.

When the microflora is out of balance (gut dysbiosis), it can increase inflammation. This condition contributes to the development of chronic inflammatory diseases, such as ischemic disease heart disease, multiple sclerosis, asthma and rheumatoid arthritis. [AND]

When the mice were treated with antibiotics, the number of anti-inflammatory T-reg immune cells in their gut was severely reduced and the mice were more prone to developing inflammation. [AND]

The “good” bacteria that can protect against inflammatory diseases include A. muciniphila and F. Prausnitzii. [AND]

Gut bacteria protect against allergies

An unbalanced intestinal microflora increases.

A study involving 1,879 volunteers found that people with allergies had a lower diversity in their gut microflora. They had a reduced number of bacteria Clostridiales (manufacturers of butyrate) and increased the number of bacteria Bacteroidales. [AND]

Several factors that interfere with the normal functioning of the intestinal microflora and contribute to the development of food allergies[AND]:

• Lack of breastfeeding during infancy
• Use of antibiotics and gastric acid inhibitors
• Use of antiseptics
• A diet low in dietary fiber (fiber) and high in fat.

Children who grew up on farms countryside), or have traveled there for extended stays, generally show a low risk of developing allergies. This is probably due to a change in the microflora in these children than in those who spend their lives in urban environments. [AND]

Another protective factor against food allergies may be having older siblings or pets. People living in the house with animals show a greater diversity of intestinal microflora. [AND]

Two studies involving 220 and 260 children showed that the use of probiotics with Lactobacillus rhamnosus (Lactobacillus rhamnosus) leads to rapid elimination of different types food allergies. The action of the probiotic is due to the increase in butyrate-producing bacteria. [AND]

Immunotherapy together with a probiotic from Lactobacillus rhamnosus led to an 82% cure for allergies in 62 children. [R] Finally, a meta-analysis of 25 studies (4,031 children) showed that Lactobacillus rhamnosus reduce the risk of eczema. [AND]

Microflora protects against the development of asthma

When examining 47 children with asthma, they revealed a low diversity of bacteria in the microflora. Their gut microflora was similar to that of infants. [AND]

By analogy with food allergy, people can protect yourself and your children from developing asthma by improving the microflora [I]:

• Breast-feeding
• older brothers and sisters
• Contact with farm animals
• Contact with pets
• High fiber diet (minimum 23 grams per day)

On the other hand, antibiotics increase the risk of asthma. Two or more courses of antibiotics during pregnancy increase the risk of asthma in offspring (based on a study of 24,690 children). [AND]

Another study in 142 children showed that the use of antibiotics in early age also increased the risk of asthma. The drugs reduced the diversity of the intestinal microflora, reduced Actinobacteria and increased Bacteroids. The decrease in the diversity of the bacterial component of the intestine persisted for more than 2 years after receiving antibiotics. [AND]

Mice on a high fiber diet showed an increased ratio of Firmicut bacteria to Bacteroides in the gut microflora. This ratio increased the production of short-chain fatty acids (SCFAs) and protected against inflammation. respiratory tract. [AND]

Neutered mice show an increased number of airway inflammations. Colonization of their intestines with bacteria from young, but not adult, mice protects against the development of these inflammations. This indicates that there is a time-specific role for gut bacteria in the development of the immune system. [AND]

Microflora involved in the development of inflammatory bowel disease

Inflammatory bowel disease (IBD) is caused by a combination of genetic, environmental and bacterial factors. IBD manifests itself in the form of ulcerative colitis and. It is believed that these diseases may be directly related to changes in the intestinal microflora. [AND]

A meta-analysis (7 studies involving 706 people) showed that people with IBD tend to have more low level Bacteroids. [AND]

Another meta-analysis (7 studies with 252 subjects) found that people with inflammatory bowel disease have more harmful bacteria, including coli and shigell . [AND]

Bacterium Faecalibacterium prausnitzii found only in humans, is one of the producers of butyric acid (butyrates) and is able to protect against inflammatory bowel diseases. The number of this bacterium is reduced in people with ulcerative colitis and Crohn's disease. [And, And]

Disturbances in the intestinal microflora contribute to the development of autoimmune diseases

Babies are less and less exposed to germs. This can increase their risk of developing autoimmune disorders because the lack of microbes in their environment inhibits the development of their immune system. As a result, immune cells are not produced in the right amount of T-reg, which leads to a loss of tolerance to microorganisms. [AND]

Short-chain fatty acids (SCFAs), produced by gut bacteria, promote tolerance by increasing circulating T-reg immune cells. [AND]

Gut microflora in type 1 diabetes

A study of 8 children with type 1 diabetes found that they had a less stable and less diverse microflora in their gut. They have fewer Firmicutes and more Bacteroids. [And] In general, they had fewer butyrate producers.

Mice prone to diabetes and treated with antibiotics were less likely to develop diabetes. Bacteria increased when mice were given antibiotics A. muciniphila . These are beneficial bacteria that may play a protective role against autoimmune diabetes(type 1 diabetes) in infants. [AND]

In another study, it was shown that mice prone to diabetes, but fed a lot of fermented(fermented) products and rich in fiber were more likely to get type 1 diabetes. This increased risk was associated with an increase in Bacteroids and a decrease in Firmicutes. [AND]

We can say that there are different opinions about the impact of altered microflora on the development of type 1 diabetes. And while it is not known for sure, either the already altered intestinal microflora stimulates type 1 diabetes, or this microflora changes already as a result of the disease. [AND]

Gut microflora in lupus

In one study of 40 patients with lupus, it was found that these individuals had more Bacteroides and fewer Firmicutes in their microflora. [AND]

Young mice prone to lupus had more Bacteroides in their microflora, which is similar to humans. The mice also showed fewer lactobacilli. But the addition of retinoic acid to the diet of these mice led to the restoration of lactobacilli and the symptoms of lupus improved. [AND]

Also lactobacilli were able to improve kidney function in female mice with kidney inflammation-induced lupus. This treatment also increased their survival time. It is known that Lactobacilli reduce inflammation in the intestine by changing the ratio between immune cells T-reg/Th17 in the direction of increasing T-reg . These circulating T-reg cells decrease the level of the cytokine IL-6 and increase the level of IL-10. This positive effect was not observed in males, suggesting a hormonal dependence of the inflammation effect. [AND]

Mice prone to lupus develop changes in their gut microflora when given water with a more acidic pH. In this case, the number of Firmicutes in the intestine increases and Bacteroides decreases. These mice showed fewer antibodies and had a slower progression of the disease. [AND]

Gut microflora in multiple sclerosis

It is known that it is associated with disturbed microflora. A general decrease in Bacteroids, Firmicuts and butyrate-producing bacteria is diagnosed. [AND]

In mice with experimental autoimmune encephalomyelitis (EAE, mouse equivalent multiple sclerosis in humans) the intestinal microflora was disturbed. Antibiotics helped make the disease less severe and reduce mortality. [And] In addition, sterile mice showed milder EAE, which was associated with impaired production of Th17 immune cells (reduced numbers). [AND]

When sterile mice were colonized with bacteria that increased the production of Th17 immune cells, such mice began to develop EAE. On the other hand, colonization of these mice with Bacteroides (beneficial bacteria) helped to protect against the development of EAE by increasing the number of circulating T-reg immune cells. [AND]

Gut microflora in rheumatoid arthritis

Science has proven that environmental factors are much more important in development (RA) than genetic predisposition. [And] These predisposing factors include the health of the gut microflora.

Patients with RA had a reduced diversity of microflora. In a 72-participant study, it was demonstrated that microflora disturbance was greater with increased disease duration and autoantibody production. [AND]

Several bacteria are known to be directly associated with the development of rheumatoid arthritis: Collinsella , Prevotellacorpi and Lactobacillussalivarius. [R] Predisposed mice colonized with Collinsella or Prevotella bacteria corpi showed a greater risk of developing arthritis, and their disease was more severe. [AND]

On the other hand, bacteria Prevotellahisticola reduced the incidence and severity of rheumatoid arthritis in mice. Prevotellahisticola reduced disease activity by increasing the number of T-reg immune cells and IL-10 cytokine, which reduced the activation of inflammatory Th17 lymphocytes. [AND]

Some probiotics have been shown to improve symptoms in patients with rheumatoid arthritis [And, And, And]:

• casei(study of 46 patients)
• acidophilus(study of 60 patients)
• Bacillus coagulans(study of 45 patients)

Gut microflora helps improve bone strength

Gut microbes also interact with our bones. However, until now this association has only been studied in animals.

In sterile mice, bone mass increases. These mice return to normal upon receiving normal gut microflora. [AND]

In addition, antibiotics led to an increase in bone density in mice. [AND]

And probiotics, mainly lactobacilli, improved bone production and strength in test animals. [AND]

Imbalance of microflora contributes to the development of autism

Up to 70% of people with autism have bowel problems. These problems include abdominal pain, increased intestinal permeability, and severe changes in the gut microflora. Problems like these mean that there is a direct link between abnormalities in the gut and brain function in autism. [AND]

small clinical trial with 18 children with autism attempted to incorporate a change in microflora with treatment of the underlying disease. This treatment included a 2-week course of antibiotics, bowel cleansing, and fecal transplant from healthy donors. As a result of this treatment, children experienced an 80% reduction in the symptoms of bowel problems (constipation, diarrhea, dyspepsia and abdominal pain). Simultaneously, the behavioral symptoms of the underlying disease also improved. This improvement was maintained 8 weeks after the end of treatment. [AND]

Sterile mice are known to exhibit impairments in social skills. They exhibit excessive self-preservation (similar to repetitive behavior in humans) and in most cases choose to be in an empty room rather than in the presence of another mouse. If the intestines of these mice are colonized with intestinal bacteria from healthy mice immediately after birth, some, but not all, symptoms improve. This means that there is a critical period during infancy when gut bacteria impact brain development. [AND]

In humans, maternal obesity may increase the risk of autism in children. [R] The likely cause is an imbalance in the gut microflora.

When mother mice were fed high products high-fat diets, their gut microflora became imbalanced and their offspring had problems socializing. If lean healthy animals lived with a pregnant female, then such social disorders in born mice occurred in very rare cases. In addition, one of the probiotics - Lactobacillus reuteri (Lactobacillus reuteri) were also able to improve these social impairments. [AND]

Disturbed gut microflora may contribute to the development of Alzheimer's disease

Sterile mice are partially protected from . Colonization of these mice with bacteria from diseased mice contributed to the development of Alzheimer's disease. [non-peer reviewed study [R])

The protein that forms amyloid plaques(b-amyloid) in Alzheimer's disease, produced by intestinal bacteria. Known bacteria - coli and Salmonella enterica (or intestinal salmonella, lat. Salmonella enterica), are on the list of many bacteria that produce b-amyloid proteins and may contribute to Alzheimer's disease. [AND]

People with disrupted gut microflora have an increased risk of developing Alzheimer's disease:

• Chronic fungal infection may increase Alzheimer's risk [R]
• People with rosacea show an altered gut microflora. They have an increased risk of developing dementia, specifically Alzheimer's disease (study of 5,591,718 people). [AND]
• Patients with diabetes have a 2-fold increased risk of developing Alzheimer's disease (study of 1,017 elderly people). [AND]

Problems with the intestinal microflora increase the risk of Parkinson's disease

A study involving 144 subjects showed that people with have an altered intestinal microflora. They have reduced the number Prevotellaceae almost 80%. At the same time, the number of enterobacteria was increased. [AND]

Mice prone to developing Parkinson's disease have fewer motor abnormalities when born sterile. But if they were colonized with bacteria or given short-chain fatty acids (SCFAs), the symptoms worsened. In this case, antibiotics were able to help improve the condition. [AND]

If sterile mice with a genetic predisposition to Parkinson's disease received intestinal bacteria from mice with the disease, their symptoms became much worse. [AND]

Disrupted gut microflora may increase risk of colon cancer

A study of 179 people found that people diagnosed with colon cancer had an increased ratio of Bacteroides/Prevotella. [AND]

Another study of 27 subjects showed that people with colon cancer had more acetate in their gut and fewer butyrate-producing bacteria. [AND]

Intestinal and other infections, as well as harmful bacteria disrupt the intestinal microflora and increase the risk colon cancer development and:

• Infection Streptococcus bovis is a risk factor for the development of colon cancer (meta-analysis of 24 studies). [AND]
• Bacterium coli enhances tumor growth in mice with inflammatory bowel disease. [AND]

Changes in gut microflora linked to chronic fatigue syndrome

In a study with 100 volunteers, it was demonstrated that chronic fatigue syndrome was associated with disturbances in the intestinal microflora. In addition, these strength of these disorders could be related to the severity of the disease. [AND]

A similar study (87 participants) found that patients with chronic fatigue syndrome had reduced bacterial diversity in their gut. In particular, a decrease in the number of Firmicuts was observed. The gut contained more inflammatory and fewer anti-inflammatory bacterial species. [AND]

A study involving 20 patients showed that physical exercises caused further disturbances in the gut microflora in people with chronic fatigue syndrome. [And] This worsening condition can be explained by the increased penetration of harmful bacteria and their metabolites through the intestinal barrier through physical exertion and spread through the bloodstream throughout the body.

Microflora contributes to the reduction of fatigue during exercise

In animal studies, it was found that the normalization of the intestinal microflora was able to increase performance and reduce fatigue during physical training. [And] Sterile mice, on the other hand, showed shorter distances during swimming trials. [AND]

Getting a Probiotic Lactobacillus plantarum contributed to increased muscle mass, paw grip strength, and exercise performance in mice . [ And]

Gut bacteria contribute to aging

Aging is often associated with disturbances in the gut microflora.. [And] Older people tend to have an overall low diversity of gut bacteria. They show a very low number of Firmicuts and a strong increase in Bacteroids. [AND]

Intestinal dysbiosis causes chronic inflammation low degree. It is also associated with a decrease in the function of the immune system (immunosenescence). Both of these conditions accompany many age-related diseases. [AND]

Two studies involving 168 and 69 Russian residents showed that had the highest bacterial diversity. They also had a large number of beneficial bacteria and microbes that produced butyrate. [And, And]

Sterile mice live longer. But if sterile animals were housed with old (but not young) mice, then pro-inflammatory cytokines in the blood increased sharply in sterile mice. [AND]

Dysbacteriosis is a condition caused by a violation of the intestinal microflora associated with a change in the species composition of bacteria. The number of useful bifidus and lactobacilli is reduced, and the number of pathogenic (pathogenic) microorganisms increases. Intestinal dysbacteriosis is not an independent disease. Often it turns out to be the result of other ailments (sometimes quite formidable). According to statistics, it is observed in 90% of adults.

In more detail about what kind of disease it is - intestinal dysbacteriosis - what are the first signs and symptoms, as well as how to properly treat adults and children with diet and medication.

What is dysbacteriosis?

Gut dysbiosis (also dysbiosis) is a condition of microbial imbalance on or within the body. With dysbacteriosis, the ratio of beneficial and conditionally pathogenic microorganisms is disturbed, for example, in the intestines or in the reproductive organs.

The adult intestine normally contains 2-3 kg of various microorganisms(about 500 species). 60% of all microorganisms are settled in the gastrointestinal tract.

Microorganisms help digest food, synthesize vitamins, remove toxins and carcinogens, break down all unnecessary elements. The main representatives of the intestinal flora are aerobic lactobacilli and anaerobic bifidobacteria.

In the human body, three types of bacteria are involved in the process of digestion of food:

• useful (bifidobacteria, lactobacilli). They maintain the ratio of other bacteria in the stomach, prevent the development of allergic diseases, weakening of the immune system and many other negative effects on the human body. They also control the amount of harmful bacteria;
• neutral . They live in a certain place. Do not bring special benefit or harm;
• harmful (candida fungus, staphylococcus aureus, streptococcus). They provoke various diseases and malfunctions of the gastrointestinal tract.

The reasons

The number of each type of bacteria that live in the intestines is controlled by the laws of natural selection: those that multiply strongly do not find food for themselves, and the extra ones die, or other bacteria create unbearable conditions for them to live. But there are situations in which the normal balance changes.

The causes of inhibition of the normal flora of the intestine during dysbacteriosis may be the following factors:

Sometimes almost completely healthy people can suffer from dysbacteriosis. In this case, the cause should be sought in the characteristics of the profession, or in seasonal changes in nutrition.

Kinds

Depending on the cause of the occurrence, the syndrome of intestinal dysbacteriosis in modern medicine is divided into several types.

• Dysbacteriosis that occurs in healthy people:
• Professional (violations occur due to harmful professional activities)
• Age (flora is disturbed due to aging of the body)
• Nutritive (associated with improper diet)
• Seasonal (flora changes depending on the time of year, mainly in cold weather).

By gravity:

• light;
• medium-heavy;
• heavy.

With the flow:

• acute (up to 30 days);
• protracted (up to 4 months): with clinical manifestations(continuous or recurrent) and without clinical manifestations;
• chronic (more than 4 months): with clinical manifestations (continuous or recurrent) and without clinical manifestations.

Dysbacteriosis of the small intestine

Dysbacteriosis of the small intestine begins to manifest itself with its excessive seeding. In this case, the microbial composition changes, which provokes a violation of the normal functioning of the gastrointestinal tract. The pain is localized in the navel.

Dysbacteriosis of the large intestine

Colon dysbacteriosis is an extremely common pathology that disrupts the microflora simultaneously in the stomach, duodenum, and intestines. The disease can be long-term, take more than severe form and disrupt the normal way of life.

Symptoms of intestinal dysbiosis

The clinical picture of the development and course of dysbacteriosis depends on both the stage and the microbiological variant of the disorder.

Characteristic signs of dysbacteriosis in adults:

• Chair disorders. Stool disorders in dysbacteriosis are one of the most common and characteristic symptoms. It most often appears as liquid stool(diarrhea). With age-related (in the elderly) dysbacteriosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).
• With pronounced processes of decay and fermentation, which are observed only in 25% of patients, the composition, shape and color of feces are disturbed. It becomes foamy, liquid, acquires a light color and a sour smell. There may be a burning sensation in the anus.
• change in the smell of feces (it becomes sharply putrid or sour);
• increased gas formation (gases are fetid and odorless, sonorous and not);
• bloating of varying intensity (it is more pronounced in the evenings, may be aggravated after certain products);
• Dyspeptic disorders: nausea, vomiting, belching, loss of appetite, are the result of impaired digestion;
• The intestines are not fully emptied.
• Rotten taste, belching.

Symptoms that manifest themselves with dysbacteriosis, not everyone can experience, this individual signs. Approximately half of those suffering from this disorder feel nothing but loose stools or constipation.

With dysbacteriosis, digestion suffers the most. Since the food in the intestines is first broken down by bacteria, and only then absorbed into the blood. Without the help of microorganisms, the body cannot absorb many nutrients. Therefore, nausea, vomiting, loose stools appear.

Stages of dysbacteriosis in adults

There are such stages of the disease:

With intestinal dysbacteriosis, other symptoms and manifestations are possible, but they will rather relate to complications of the disease or to an exacerbation of comorbidities. These symptoms are not directly related to a violation of the intestinal microflora. Possible, for example, signs of hypovitaminosis and beriberi. Vitamin deficiency is due to the fact that it is not absorbed normally in the intestines.

Diagnostics

With intestinal dysbacteriosis, symptoms are observed such as enterocolitis, inflammation of the colon, small intestine. The task of the doctor is to make the correct diagnosis, excluding the above pathologies of the digestive system.

It is difficult to diagnose dysbacteriosis without tests. The symptoms of the disease are very similar to the symptoms of other diseases. To make a diagnosis, the doctor needs to have the results of the diagnosis. After collecting the patient's complaints and palpation, the specialist prescribes 2-3 necessary procedures.

To make an accurate diagnosis will help:

• Fecal analysis. The most specific technique laboratory diagnostics intestinal dysbacteriosis - analysis and culture of feces.
• Clinical blood test - shows the presence of inflammation and possible bleeding in the intestine. With severe dysbacteriosis, a decrease in the level of hemoglobin in the blood is noted.
• Colonoscopy. Allows you to assess the condition of a segment of the intestine up to one meter long.
• Ultrasound examination of the abdominal cavity. With its help, comorbidities can be detected.
• Fibroesophagogastroduodenoscopy. It consists in examining the mucous membrane of the stomach, esophagus and duodenum performed using an endoscope.
• X-ray of the intestine. To detect pathological changes, a contrast agent is used during the procedure.

Treatment of dysbacteriosis in adults

With a mild degree of imbalance in the intestinal microflora, it may be enough to eliminate these causes through a balanced diet, taking prebiotics or probiotics. At severe violation along with complex antimicrobial therapy, dietary nutrition is also indicated.

How to treat intestinal dysbiosis? Treatment measures consist of:

• elimination of excess bacterial contamination of the small intestine;
• restoration of the normal microbial flora of the colon;
• improving intestinal digestion and absorption;
• restoration of impaired intestinal motility;
• stimulation of the reactivity of the body.

Medications

For the treatment of dysbacteriosis, drugs are used that help restore the normal intestinal flora. Usually, one of the following groups is selected:

1. Antibacterial drugs necessary primarily to suppress the overgrowth of microbial flora in the small intestine. The most widely used antibiotics are from the group of tetracyclines, penicillins, cephalosporins, quinolones (tarivid, nitroxoline) and metronidazole.
2. Bacteriophages (intestibacteriophage, staphylococcal bacteriophage, pyobacteriophage, coliproteic bacteriophage, etc.);
3. Antibiotics (fluoroquinolones, cephalosporins, penicillins, macrolides, aminoglycosides, etc.);
4. Probiotics for dysbacteriosis (sporobacterin, enterol, cereobiogen, bactisubtil, etc.).
5. Antifungal agents. They are prescribed when an increased amount of yeast fungi is found in the intestinal contents.
6. Enzymes are prescribed in case of severe digestive disorders. Tablets Mezim 1 tablet 3 times a day, before meals. In order to improve the absorption function, Essentiale, Legalon or Carsil are prescribed, since they stabilize the membranes of the intestinal epithelium. Imodium (loperamide) and trimebutine (debridate) improve bowel propulsion.
7. Sorbents are prescribed for pronounced signs of intoxication. Activated carbon 5-7 tablets are prescribed for 1 time, for 5 days.

Appoint medications from dysbacteriosis, determine their dosage and duration of administration only a doctor can. Self-medication threatens with the occurrence of complications.

At long-term treatment antibiotics, it is imperative to include in therapy a special diet containing foods rich in beneficial bacteria, antifungal and immunostimulating, as well as antihistamine therapy.

Treatment of intestinal dysbacteriosis is prescribed in a complex, depending on the degree of the disease. Since the disease develops under the influence of many factors, it is important to eliminate the cause of its development, otherwise taking probiotics will not give a positive effect. Elimination of foci of infection and chronic diseases is the main task in treatment.

Diet and proper nutrition

There is no special diet for each person, just follow some rules, avoid unwashed fruits, low-quality products and take food every three hours in small portions. It is important to consume hot liquid food every day: soup, broth.

The basic principles of proper nutrition for dysbacteriosis:

• regular meals at the same time;
• eating warm food (within 25-40 degrees) and avoiding too cold or hot food;
• avoidance of aggressive and spicy foods;
• thorough chewing of food;
• frequent eating (every two and a half hours) and in small portions;
• drink plenty of water, but not with meals (so as not to interfere with the digestion of food).

When following a diet, it is allowed to eat the following foods:

• white or Rye bread- not fresh, but yesterday;
• crackers;
• soups on low-fat broths with grated cereals and vegetables;
• meat dishes boiled, steamed or stewed;
• lean meats;
• lean fish boiled, steamed, stewed or fried without breading;
• vegetables (excluding cabbage, legumes and mushrooms) boiled, baked or steamed;
• fruits and berries as part of jelly, compote, puree or mousse;
• baked or raw grated apples;
• low-fat dairy products;
• butter in small quantities;
• sauces without spices;
• all drinks except for alcoholic, carbonated, kvass and fruit drinks.

Along with the diet, patients may be prescribed probiotics and prebiotics. These drugs improve bowel function and restore a healthy composition of the flora.

Folk remedies

ethnoscience, if proven remedies are used correctly, can improve the condition and alleviate the symptoms of the disease. But it can only be used as an addition to the main treatment prescribed by the doctor.

As an alternative treatment are allowed:

• plants that give an antiseptic effect: pomegranate and rosehip juice diluted with water, strawberries, raspberries;
• analgesic effect gives mint extract, chamomile tea, decoctions of St. John's wort;
• have an astringent effect, anti-inflammatory blueberries, bird cherry, beets.

Folk methods include the use of the following means:

1. Oak bark . A decoction of oak bark has an astringent effect and helps with diarrhea, which often accompanies dysbacteriosis. A tablespoon of raw materials, poured with 250 ml of boiling water, simmer over low heat for a quarter of an hour. The liquid is cooled, filtered and taken in half a glass up to 3 times a day.
2. Garlic . It contains antibacterial compounds that destroy pathogenic microflora and prevent the development of putrefactive processes. To prepare the medicine, you need to crush a clove of garlic in a mortar and pour it with a glass of fat-free kefir. Drink 2 glasses of this drink every day.
3. A useful and tasty cure for dysbacteriosis is a mixture of sunflower seeds, pumpkins and walnut kernels. Well-dried ingredients must be ground in a coffee grinder and take 2 tablespoons of the resulting powder daily with warm water.
4. Serum. Sold in stores or left after making homemade cottage cheese. Heated whey is drunk in the morning on an empty stomach for a month, 1 glass each.
5. If the digestion of food is accompanied by bloating. Pour 4 tablespoons of dill seeds in a glass of hot water, leave for 2 hours, then strain and drink every 2 hours throughout the day.
6. Based on propolis honey: a teaspoon of this honey should be diluted in a glass of warm water or rosehip broth and taken 2 times a day after meals for 1.5 months.
7. The simplest options herbal decoction - This is eucalyptus and mint. To prepare the first 3 tbsp. dry eucalyptus pour 500 ml of boiling water. For the second recipe, boiling water is taken 2 times less - 250 ml. Eucalyptus decoction is drunk in a quarter cup 3 times a day, and mint in 3 quarters of a cup 4 times a day. The course of treatment is designed for 14 days.

Treatment exclusively with herbs is possible only in case of mild dysbacteriosis. In other cases, folk methods are just an addition to the main treatment prescribed by a specialist.

Prevention

Preventive measures include adherence to recommendations for proper nutrition, hygiene and food hygiene.

The main preventive measures for adults are as follows:

• healthy eating;
• taking antibiotics only as prescribed by a doctor;
• timely treatment of diseases of the digestive system.

To get rid of dysbacteriosis and prevent further relapses, it is most effective to use an integrated approach. At the first symptoms, be sure to seek help from a gastroenterologist. Be healthy and always watch your lifestyle!

The intestinal microflora (intestinal biocenosis) begins to form from the moment the child is born. In 85% of children, it is finally formed during the first year of life. In 15% of children, the process takes a longer period. Providing for a child in the first half of the year breast milk is an important stabilizing factor.

Bifidobacteria, lactobacilli, and bacteroids ensure the normal functioning of the human body. They account for 99% of the normal intestinal microflora.

Rice. 1. Intestinal bacteria. Computer visualization.

What is the intestinal microflora

Rice. 2. View of the wall of the small intestine in section. Computer visualization.

Up to 500 species of various microorganisms are found in the human intestine. Their total weight is more than 1 kg. The number of microbial cells exceeds the total cellular composition organism. Their number increases along the course of the intestine, and in the large intestine, bacteria already make up 1/3 of the dry residue of feces.

The microbial community is seen as a separate, vital organ human body(microbiome).

The intestinal microflora is constant. This is due to the presence of receptors in the small and large intestine, which are adapted for adhesion (sticking together) of certain types of bacteria.

Aerobic flora prevails in the small intestine. Representatives of this flora use free molecular oxygen in the process of energy synthesis.

Anaerobic flora prevails in the large intestine (lactic acid and Escherichia coli, enterococci, staphylococci, fungi, proteus). Representatives of this flora synthesize energy without oxygen access.

In different parts of the intestine, the intestinal microflora has a different composition. Most microorganisms live in the parietal region of the intestine, much less - in the cavities.

Rice. 3. Intestinal microflora is concentrated in the parietal zone of the intestine.

The total area of ​​the intestine (its inner surface) is approximately 200 m2. Streptococci, lactobacilli, bifidobacteria, enterobacteria, fungi, intestinal viruses, non-pathogenic protozoa live in the intestine.

A person owes the normal functioning of the body to bifidobacteria, lactobacilli, enterococci, Escherichia coli and bacteriods, which account for 99% of the normal intestinal microflora. 1% are representatives of opportunistic flora: clostridium, staphylococcus, proteus, etc.

Bifidobacteria and lactobacilli, Escherichia and acidophilus bacilli, enterococci are the basis of the human intestinal microflora. The composition of this group of bacteria is always constant, numerous and performing basic functions.

Rice. 4. In the photo, an acidophilus bacillus destroys pathogenic bacteria shigella (Shigella flexneri).

Escherichia coli, enterococci, bifidobacteria and acidophilus bacteria inhibit the growth of pathogenic microorganisms.

The intestinal microflora undergoes qualitative and quantitative changes during a person's life. It changes with age. Microflora depends on the nature of nutrition and lifestyle, climatic conditions of the region of residence, season.

Changes in the intestinal microflora do not go unnoticed for a person. Sometimes they proceed latently (asymptomatically). In other cases - with pronounced symptoms of an already developed disease. With the active work of intestinal bacteria, toxic substances are formed that are excreted in the urine.

Rice. 5. The inner surface of the large intestine. Pink islets are clusters of bacteria. Three-dimensional computer image.

Groups of microorganisms of the intestinal microflora

• The main group is represented by bifidobacteria, lactobacilli, normal E. coli, enterococci, peptostreptococci and propionobacteria.
• Conditionally pathogenic flora and saprophytes are represented by bacteroids, staphylococci and streptococci, yeast-like fungi, etc.
• transient flora. This microflora accidentally enters the intestines.
• Pathogenic flora is represented by pathogens of infectious diseases - shigella, salmonella, yersinia, etc.

Functions of the intestinal microflora

The intestinal microflora performs many important functions for humans:

• The intestinal microflora plays an important role in maintaining local and general immunity. Thanks to it, the activity of phagocytes and the production of immunoglobulin A increase, the development of the lymphoid apparatus is stimulated, which means that the growth of pathogenic flora is suppressed. With a decrease in the function of the intestinal microflora, the state of the body's immune system first of all suffers, which leads to the development of staphylococcal, candidal, aspergillus and other types of candidiasis.

• The intestinal microflora contributes to the normal trophism of the intestinal mucosa, thereby reducing the penetration into the blood of various food antigens, toxins, viruses and microbes. In violation of the trophism of the intestinal mucosa, a lot of pathogenic flora penetrates into the human blood.
• Enzymes produced by the intestinal microflora are involved in the process of splitting bile acids. Secondary bile acids are reabsorbed, and a small amount (5-15%) is excreted in the feces. Secondary bile acids are involved in the formation and promotion of feces, preventing their dehydration. If there are too many bacteria in the intestines, then bile acids begin to break down prematurely, which leads to secretory diarrhea (diarrhea) and steatorrhea (excretion of increased amounts of fat). The absorption of fat-soluble vitamins is impaired. Cholelithiasis often develops.
• The intestinal microflora is involved in the utilization of fiber. As a result of this process, short-chain fatty acids are formed, which are a source of energy for the cells of the intestinal mucosa. With an insufficient amount of fiber in the human diet, the trophism of intestinal tissues is disrupted, which leads to increased permeability of the intestinal barrier to toxins and pathogenic microbial flora.
• With the participation of bifido-, lacto-, enterobacteria and E. coli, vitamins K, C, group B (B1, B2, B5, B6, B7, B9 and B12), folic and nicotinic acids are synthesized.
• The intestinal microflora maintains water-salt metabolism and ionic homeostasis.
• Due to the secretion of special substances, the intestinal microflora inhibits the growth that causes putrefaction and fermentation.
• Bifido-, lacto-, and enterobacteria take part in the detoxification of substances that enter from the outside and are formed inside the body itself.
• The intestinal microflora increases the resistance of the intestinal epithelium to carcinogens.
• Regulates intestinal peristalsis.
• The intestinal microflora acquires the skills to capture and remove viruses from the host organism, with which it has been in symbiosis for many years.
• The intestinal flora maintains the body's thermal balance. The microflora feeds on substances that are not digested by the enzymatic system of substances coming from the upper sections of the gastrointestinal tract. As a result of complex biochemical reactions, a huge amount of thermal energy is produced. Heat is carried throughout the body with blood flow and enters all internal organs. That is why a person always freezes when starving.

The positive role of certain types of bacteria in the intestinal microflora

A person owes the normal functioning of the body to bifidobacteria, lactobacilli, enterococci, Escherichia coli and bacteriods, which account for 99% of the normal intestinal microflora. 1% are representatives of opportunistic flora: clostridia, Pseudomonas aeruginosa, staphylococcus, proteus, etc.

bifidobacteria

Rice. 6. Bifidobacteria. Three-dimensional computer image.

• Thanks to bifidobacteria, acetate and lactic acid are produced.
  By acidifying their habitat, they inhibit the growth that causes decay and fermentation.
• Bifidobacteria reduce the risk of developing food allergies in babies.
• Bifidobacteria provide antioxidant and antitumor effects.
• Bifidobacteria are involved in the synthesis of vitamin C.

coli

• Special attention is paid to the representative of this genus Escherichia coli M17. E. coli (Escherichia coli M17) is able to produce the substance cocilin, which inhibits the growth of a number of pathogenic microbes.
• With the participation of Escherichia coli, vitamins K, group B (B1, B2, B5, B6, B7, B9 and B12), folic and nicotinic acids are synthesized.

Rice. 7. Escherichia coli. Three-dimensional computer image.

Rice. 8. Escherichia coli under a microscope.

lactobacilli

• Lactobacilli inhibit the growth of putrefactive and conditionally pathogenic microorganisms due to the formation of a number of antimicrobial substances.
• Bifido- and lactobacilli are involved in the absorption of vitamin D, calcium and iron.

Rice. 9. Lactobacilli. Three-dimensional computer image.

The use of lactic acid bacteria in the food industry

Lactic acid bacteria include lactic streptococci, creamy streptococci, bulgarian, acidophilic, cereal thermophilic and cucumber sticks. Lactic acid bacteria are widely used in the food industry:

• in the production of curdled milk, cheeses, sour cream and kefir;
• produce lactic acid, which ferments milk. This property of bacteria is used for the production of curdled milk and sour cream;
• in the preparation of cheeses and yogurts on an industrial scale;
• lactic acid serves as a preservative during the brining process.
• when fermenting cabbage and pickling cucumbers, they take part in urinating apples and pickling vegetables;
• they give a special flavor to wines.

Bacteria of the genus Streptococcus and Lactobacillus give the products a thicker consistency. As a result of their vital activity, the quality of cheeses improves. They give the cheese a certain cheese flavor.

Rice. 10. Colony of acidophilus bacillus.

Intestinal dysbiosis is a condition in which the ratio of bacteria that inhabit the human intestine is disturbed. In such a situation, there are fewer beneficial microorganisms, and more harmful ones. This can lead to the appearance of diseases and disruption of the digestive tract.

Causes of violations

The development of pathogenic microbes can cause such actions:

Unfortunately, the first and second degree of dysbacteriosis is practically not diagnosed. Therefore, the symptoms of the development of bacteria in the intestine can be determined only at the third and fourth stages of the disease.

Stool disorder:

1. Those suffering from dysbacteriosis complain of constant diarrhea. This is due to increased intestinal peristalsis and excessive secretion of acids. Sometimes the stool may be contaminated with blood or mucus. The excrement has a rotten smell;
2. Age-related disruption of the digestive tract can lead to the development of constipation. The absence of normal flora significantly reduces peristalsis.

Bloating:

• Spasmodic pain. Excessive gas formation contributes to an increase in pressure in the intestines. If the patient suffers from a disorder of the small intestine, he often complains of spasmodic pain in the navel. If a violation of the microflora is observed in the large intestine, abdominal pain on the right side;
• Disorders. Nausea, lack of appetite and vomiting indicate a violation of the digestive processes;
• Dryness and also pallor skin, deterioration of nails and hair, stomatitis;
• Allergy. Often, patients have skin rashes and itching. As a rule, they are caused by products that were previously normally absorbed by the body;
• Intoxication. Fatigue, headache, and temperature indicate the accumulation of decay products in the body.

Can there be complications?

The development of putrefactive bacteria in the human intestine can also provoke complications:

1. Sepsis. If pathogens are absorbed into human blood, it can cause infection;
2. Enterocolitis. If the patient did not go to the doctor in time, he may develop chronic inflammation of the large and small intestines;
3. Anemia. The absence of normal flora does not allow a sufficient amount of trace elements and vitamins to be absorbed into the blood, which is reflected in the level of hemoglobin in it;
4. Peritonitis. A large number of "bad" pathogenic intestinal bacteria destructively affects the gastrointestinal tissue, this can lead to the release of contents into abdominal cavity;
5. Weight loss . As a person's appetite decreases, this leads to significant weight loss.

How to treat?

Treatment of the intestines from harmful bacteria is carried out with the help of special preparations that inhibit the development of pathogenic flora. The types of medicines, their dosage and the duration of the course of treatment can only be determined by doctors. Therefore, before taking the medicine, be sure to consult a doctor.

Drugs used for dysbacteriosis:

• Probiotics. Medicines contain live beneficial bacteria that restore the microflora. They are used to treat the disease at stages 2-4;
• Prebiotics. These drugs have a bifidogenic property. They are able to stimulate the reproduction of "good" microbes, which subsequently crowd out "harmful" microorganisms;
• Symbiotics. These are combined types of drugs that include both prebiotics and prebiotics. Such drugs stimulate the growth and development of the missing beneficial bacteria;
• Sorbents. Assign during intoxication of the body to remove metabolic products;
• Antibacterial medicines. Most often they are prescribed already at the 4th degree of the disease, when it is necessary to fight the development of harmful intestinal bacteria;
• Antifungal medicines. If fungal formations of the Candida type are found in the excrement, the doctor will prescribe an antifungal drug that eliminates any yeast-like formations;
• Enzymes. With gastrointestinal disorders, enzymes "help" beneficial bacteria in food processing.

Dieting

To correct the microflora, it is very important to follow the diet prescribed by the attending physician. First of all, any kind of alcoholic beverages, fatty and too spicy foods, sweets (cakes, cakes, lollipops, sweets), smoked foods and pickles should be excluded from the diet.

All these products only increase fermentation processes, and this also affects the intestinal flora.

You need to eat often, but the portions should not be huge. It is advisable to have 4 to 5 meals during the day. To improve the functioning of the digestive tract, try not to drink water, coffee and carbonated drinks with meals. Any liquid reduces the concentration of gastric juice, and this makes food digest longer.

Products that increase flatulence, be sure to exclude:

1. beans;
2. peas;
3. sparkling water;
4. bakery products with bran;

But the proteins in the diet should be increased. Give preference only to lean meat, which is best eaten either stewed or boiled.

The term "Dysbacteriosis", comes from the Greek "dys", which means "negation" and the words "bacteria", "bacteria or microorganism". Intestinal dysbacteriosis is a quantitative and qualitative violation of the normal intestinal flora. The human intestine is inhabited by bacteria, about 2/3 of the contents of the large and small intestines are represented by microorganisms. A certain quantity and quality of such microorganisms constitute the normal intestinal microflora. Normal intestinal flora is a biomass of obligate (mandatory) microbes involved in the development of immunity. With intestinal dysbacteriosis, there is a violation of the production of immunity, the colonization of foreign microorganisms, and the development of putrefactive flora, instead of normal. As a result, the putrefactive flora causes chronic inflammation of the intestine, with characteristic clinical manifestations. An imbalance between microorganisms is the background for the development of various intestinal diseases (the most dangerous is intestinal cancer).

Anatomy and physiology of the intestine

In order to understand in which anatomical formations dysbacteriosis occurs, for this we will talk a little about the anatomy of the intestine.

The intestine is the longest section of the digestive tract, located in the abdominal cavity, originates from the pylorus and ends anus. The length of the entire intestine is about 4 meters. It is divided into small intestine and large intestine, each of which has its own anatomical features.

1. Small intestine, is initial department intestine, consists of loops, longer than the thick one (from 2.2 to 4.4 m) and smaller in diameter (from 5 to 3 cm). Processes of digestion of proteins, fats and carbohydrates take place in it. The small intestine begins at the pylorus and ends at the ileocecal angle. The small intestine is divided into 3 sections:

• The initial section - the duodenum, starts from the pylorus of the stomach, has the shape of a horseshoe, goes around the pancreas;
• The jejunum is a continuation of the duodenum, it is approximately the initial 6-7 loops of the small intestine, the border between them is not expressed;
• The ileum is a continuation of the jejunum, represented by the following 7-8 loops. It ends with a confluence at a right angle into the initial part of the large intestine (caecum).

1. Colon, represents the final section of the digestive tract, it absorbs water and forms formed feces. It is located so that it borders (surrounds) the loops of the small intestine. Its wall forms protrusions (gaustra), which is one of the differences from the wall of the small intestine. The length of the large intestine is about 150 cm and the diameter is from 8 to 4 cm, depending on the department. The large intestine consists of the following sections:

• The caecum with the appendicular process is the initial section of the large intestine, located below the ileocecal angle, its length is from 3 to 8 cm;
• ascending part colon, is a continuation of the caecum, occupies the extreme right lateral position of the abdominal cavity, rises up from the level ilium to the level of the lower edge of the right lobe of the liver, and ends with the right bend of the colon;
• The transverse colon, starts from the right colonic flexure (the level of the right hypochondrium), runs in the transverse direction and ends with the left flexure of the colon (the level of the left hypochondrium);
• The descending part of the colon occupies the extreme left lateral position of the abdominal cavity. It starts from the left bend of the colon, goes down to the level of the left ilium;
• The sigmoid colon, 55 cm long, is a continuation of the previous section of the intestine, and at the level of the 3rd sacral vertebra passes into the next section (rectum). Diameter sigmoid colon, compared with the diameter of the rest of the large intestine, the smallest is about 4 cm;
• The rectum, is the final section of the large intestine, has a length of about 18 cm. It starts from the level of the 3rd sacral vertebra (the end of the sigmoid colon) and ends with the anus.

What is normal intestinal flora?

Microbes that live in the human intestine are vital to the human body. The approximate amount of normal intestinal flora is about 10 14 microbes, which corresponds to 2 kilograms and includes about 500 types of bacteria. The concentration of microbes in different parts of the intestine is not the same: in the duodenum and jejunum about 10 5 microorganisms per 1 ml of intestinal contents, in the ileum about 10 7 - 10 8 , in the large intestine about 10 11 microorganisms per 1 g of feces.
Normally, the intestinal flora is represented by 2 groups of bacteria:

• Obligatory bacteria bifidobacteria (make up about 85-95% of the flora), lactobacilli (1-5% of the flora), coli(escherichia), enterococci, peptostreptococci), are always part of the normal flora;
• Facultative bacteria (peptococci, staphylococci, yeast-like fungi, clostridia and others), they are optional and non-permanent representatives. They enter the intestines with insufficiently thermally processed food. This group of bacteria is often present in healthy people without causing any problems, but with a decrease in immunity, they multiply and develop various infectious diseases of the intestine.

Normal composition of bacteria in the intestine

• bifidobacteria - 10 9 - 10 10 CFU / g;
• lactobacilli - 10 7 - 10 8 CFU / g;
• bacteroids - 10 7 - 10 9 CFU / g;
• Escherichia - 10 6 - 10 8 CFU / g;
• peptococci and peptostreptococci - 10 5 - 10 6 CFU / g;
• eubacteria - 10 3 - 10 5 CFU/g;
• staphylococci - 103 CFU/g;
• streptococci - 10 4 - 10 5 CFU / g;
• clostridia - 10 5 - 10 7 CFU / g;
• yeast-like mushrooms - 10 9 - 10 10 CFU / g;
• conditionally pathogenic enterobacteria - 10 3 CFU / g.

Functions of normal intestinal microflora

1. protective function, is to prevent the colonization of foreign microorganisms in the intestine, which can cause various infectious diseases intestines. Microbes (bifidobacteria) of the normal intestinal flora produce special substances (milk and acetic acid), which inhibit the development of foreign microbes. In order for foreign bacteria to gain a foothold on the intestinal mucosa, they need to displace the normal flora, but the latter interfere with this process, since the place is already “occupied”.
2. Stimulation of immunity, due to bifidobacteria, is to stimulate the formation of antibodies and other substances (cytokines, interferons) involved in the development of immunity.
3. Removal of toxins (detoxification function), consists in the absorption of various toxins (phenols, heavy metal compounds, and others), by bifidobacteria of the intestinal flora.
4. digestive function, bacteria of the intestinal flora are involved in the breakdown of proteins, fats, carbohydrates, to amino acids, fatty acids and monosaccharides. They also increase intestinal motility, preventing the development of constipation.
5. synthesizing function, bacteria of the normal intestinal flora are involved in the formation of vitamins (B, K, C), some acids, enzymes.
6. regulatory function, those. flora bacteria, regulate the gas composition of the intestine, water-salt metabolism, cholesterol and others.
7. Anticarcinogenic (anticancer) action, consists in the absorption by bifidobacteria of the precursors of cancer cells.
8. Antiallergic action, occurs with the help of lactobacilli.

Symptoms of intestinal dysbiosis

The 1st degree and most often the 2nd degree of intestinal dysbacteriosis are not clinically manifested.
Symptoms characteristic of the 3rd and 4th degree of intestinal dysbacteriosis:

1. Stool disorder:

• Most often it manifests itself in the form of loose stools (diarrhea), which develops as a result of increased formation of bile acids and increased intestinal motility, inhibiting the absorption of water. Later the stool becomes foul-smelling, tainted with blood or mucus;
• With age-related (in the elderly) dysbacteriosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).

1. Bloating, due to the increased formation of gases in the large intestine. The accumulation of gases develops as a result of impaired absorption and removal of gases by an altered intestinal wall. Swollen intestines can be accompanied by rumbling, and cause unpleasant sensations in the abdominal cavity in the form of pain.
2. Cramping pain associated with an increase in pressure in the intestines, after the discharge of gases or stools, it decreases. With dysbacteriosis of the small intestine, pain occurs around the navel, if the large intestine suffers, the pain is localized in the iliac region (lower abdomen on the right);
3. Dyspeptic disorders: nausea, vomiting, belching, loss of appetite, are the result of impaired digestion;
4. allergic reactions , in the form of skin itching and rashes, develop after eating foods that usually did not cause allergies, is the result of insufficient antiallergic action, disturbed intestinal flora.
5. Symptoms of intoxication: there may be a slight increase in temperature up to 38 0 C, headaches, general fatigue, sleep disturbance, are the result of the accumulation of metabolic products (metabolism) in the body;
6. Symptoms that characterize a lack of vitamins: dry skin, seizures around the mouth, pale skin, stomatitis, changes in hair and nails, and others.

Complications and consequences of intestinal dysbacteriosis

• Chronic enterocolitis, is a chronic inflammation of the small and large intestines, which develops as a result of long-term action of the pathogenic intestinal flora.

• Deficiency of vitamins and microelements in the body, leads to the development of iron deficiency anemia, hypovitaminosis of B vitamins and others. This group of complications develops as a result of impaired digestion and absorption in the intestine.
• Sepsis(blood infection), develops as a result of pathogenic flora from the intestines entering the patient's blood. Most often, such a complication develops with untimely treatment of the patient for medical care.
• Peritonitis, develops as a result of the aggressive action of pathogenic flora on the intestinal wall, with the destruction of all its layers and the release of intestinal contents into the abdominal cavity.
• Accession of other diseases as a result of reduced immunity.
• Gastroduodenitis, pancreatitis, develop as a result of the spread of pathogenic intestinal flora along the digestive tract.
• Decreased patient weight, develops as a result of impaired digestion.

Diagnosis of intestinal dysbacteriosis

The diagnosis of intestinal dysbacteriosis is made on the basis of the patient's complaints, an objective examination and the results of a microbiological study of feces.

1. With the help of an objective examination, which includes palpation of the abdomen, pain is determined along the course of the small and / or large intestine.
2. Microbiological examination of feces: performed to confirm the diagnosis, intestinal dysbacteriosis.

Indications for microbiological examination of feces:

• Intestinal disorders are long-term, in cases where it is not possible to isolate a pathogenic microorganism;
• Long recovery period after acute intestinal infections;
• The presence of purulent-inflammatory foci that are not amenable to antibiotic therapy;
• Impaired bowel function in individuals undergoing radiotherapy or exposure to radiation;
• Immunodeficiency states (AIDS, cancer and others);
• Backlog baby in physical development and others.

Rules for taking feces for microbiological research: before taking feces, for 3 days, it is necessary, it is necessary to be on a special diet that excludes products that increase fermentation in the intestines (alcohol, lactic acid products), as well as any antibacterial drugs. Feces are collected in a special sterile container, equipped with a lid, with a screwed-in spoon. In order to correctly evaluate the results, it is recommended to conduct a study 2-3 times, with an interval of 1-2 days.

Degrees of intestinal dysbacteriosis
There are 4 degrees of intestinal dysbacteriosis:

• Grade 1: characterized by a quantitative change in the ischerichia in the intestine, the bifidoflora and lactoflora are not changed, most often they are not clinically manifested;
• Grade 2: quantitative and qualitative changes in ischerichia, i.e. a decrease in the amount of bifidoflora and an increase in opportunistic bacteria (fungi and others), accompanied by local inflammation of the intestines;
• Grade 3: change (decrease) in bifido and lactoflora and the development of opportunistic flora, accompanied by intestinal dysfunction;
• Grade 4: the absence of bifidoflora, a sharp decrease in lactoflora and the growth of opportunistic flora, can lead to destructive changes in the intestine, followed by the development of sepsis.

Treatment of intestinal dysbacteriosis

Medical treatment

Treatment of intestinal dysbacteriosis is carried out with the help of drugs that restore the normal flora of the intestine and correct other disorders in the body (with the help of enzymes, sorbents, vitamins). The dosage, duration of treatment and a group of drugs are prescribed by the attending physician, depending on the degree of dysbacteriosis. The dosages of drugs for adults are indicated below, for children the dosage depends on the weight and age of the child.
Groups of drugs used in intestinal dysbacteriosis:

1. Prebiotics- have a bifidogenic property, i.e. contribute to the stimulation and growth and reproduction of microbes that are part of the normal intestinal flora. Representatives of this group include: Khilak-forte, Dufalac. Hilak-forte is prescribed 40-60 drops 3 times a day.
2. Probiotics (eubiotics), these are preparations containing live microorganisms (i.e. bacteria of the normal intestinal flora), they are used to treat dysbacteriosis of 2-4 degrees.

• 1st generation drugs: Bifidumbacterin, Lifepack probiotics. They are liquid concentrates of lactobacilli and bifidobacteria, they are not stored for a long time (about 3 months). This group of drugs is unstable under the influence of gastric juice or enzymes of the gastrointestinal tract, which leads to their rapid destruction and insufficient concentration of them, the main disadvantage of 1st generation probiotics. Bifidumbacterin is administered orally, 5 doses of the drug 2-3 times a day, 20 minutes before meals;
• 2nd generation drugs: Baktisubtil, Flonivin, Enterol. They contain spores of bacteria of the normal intestinal flora, which in the patient's intestines secrete enzymes for the digestion of proteins, fats and carbohydrates, stimulate the growth of bacteria of the normal intestinal flora, and also suppress the growth of putrefactive flora. Subtil is prescribed 1 capsule 3 times a day, 1 hour before meals;
• 3rd generation drugs: Bifikol, Lineks. They consist of several types of bacteria of the normal intestinal flora, therefore they are highly effective compared to the previous 2 generations of probiotics. Linex is prescribed 2 capsules 3 times a day;
• 4th generation drugs: Bifidumbacterin forte, Biosorb-Bifidum. This group of drugs is bacteria of the normal intestinal flora in combination with an enterosorbent (with activated charcoal or others). Enterosorbent, necessary to protect microorganisms, when passing through the stomach, it actively protects them from inactivation by gastric juice or enzymes of the gastrointestinal tract. Bifidumbacterin forte is prescribed 5 doses 2-3 times a day, before meals.

1. Symbiotics(Bifidobak, Maltodofilus) , represent combined preparations(prebiotic + probiotic), i.e. at the same time stimulate the growth of normal flora and replace the missing amount of microbes in the intestine. Bifidobak is prescribed 1 capsule 3 times a day, with meals.
2. Antibacterial drugs, are used for the 4th degree of intestinal dysbacteriosis, to destroy the pathogenic flora. The most commonly used antibiotics are: groups of tetracyclines (Doxycycline), cephalosporins (Cefuroxime, Ceftriaxone), penicillins (Ampiox), nitroimidazoles: Metronidazole is prescribed 500 mg 3 times a day, after meals.
3. Antifungal drugs(Levorin) , are prescribed if there are yeast-like fungi such as Candida in the feces. Levorin is prescribed for 500 thousand units 2-4 times a day.
4. Enzymes, are prescribed in case of severe digestive disorders. Tablets Mezim 1 tablet 3 times a day, before meals.
5. Sorbents, are prescribed for severe signs of intoxication. Activated charcoal is prescribed 5-7 tablets at a time, for 5 days.
6. Multivitamins: Duovit, 1 tablet 1 time per day.

Diet for intestinal dysbacteriosis

Diet therapy is important point in the correction of intestinal flora. In case of intestinal dysbacteriosis, it is first necessary to exclude the use of alcoholic beverages, spicy, fatty foods, smoked meats and foods that enhance fermentation processes in the intestines: sweets (cakes, sweets, and others), homemade pickles, sauerkraut. Secondly, you need to eat fractionally, at least 4 times a day. Try not to drink water while eating, as it dilutes gastric juice and the food is not digested enough. Exclude from the diet products that increase flatulence (formation of gases) and intestinal motility: legumes (beans, peas, soybeans and others), bran bread, carbonated drinks. It is necessary to increase the amount of protein in the diet due to meat (lean), cooked in boiled or stewed form. Try not to eat fresh bread, dry it a little before eating.

Try to cook all food with herbs (parsley, dill and others), as it enhances the action of normal intestinal flora against pathogenic ones. Foods that enhance the restoration of intestinal microflora include: wheat, rice, buckwheat, oats, fresh vegetables or salads, non-acidic fruits. Indispensable products for restoring normal intestinal microflora are all lactic acid products: kefir, fermented baked milk, curdled milk and others. You can also use special products that are enriched with biocultures: yoghurts, biokefirs and others. Applesauce has excellent prebiotic properties, and it also has an astringent effect and is recommended for diarrhea. Before going to bed, it is recommended to drink a glass of kefir.

Prevention of intestinal dysbacteriosis

In the first place in the prevention of intestinal dysbacteriosis, is correct application antibiotics, which are one of the main reasons for disrupting the normal flora. Antibiotics should be used strictly according to the indications, after the results of a bacteriological study with an antibiogram. In order to choose the dose of an antibiotic for a particular patient, the attending physician must take into account the age and weight of the patient. In no case should you self-medicate by taking antibiotics for mild illnesses (for example: runny nose). In cases where you have been prescribed long-term antibiotic therapy, it is necessary to take them, in parallel with prebiotics, with periodic monitoring of the state of the intestinal flora (microbiological examination of feces).
In second place in the prevention of intestinal dysbacteriosis is a balanced diet and a rational regimen.

In third place, there are all acute and chronic diseases that lead to intestinal dysbacteriosis, primarily diseases of the gastrointestinal tract. Restorative therapy for patients with chronic diseases. Timely treatment such diseases, can reduce the number of patients with intestinal dysbacteriosis.

Persons who are exposed to occupational hazards (radiation) should include fermented milk products in their diet.

Is there intestinal dysbacteriosis in general? Does such a disease exist?

Officially, there is no such diagnosis. Dysbacteriosis is not an independent disease, but always a consequence of any other diseases. By itself, the change in the composition of the intestinal microflora is not the main problem. Usually, as soon as the underlying disease is cured, dysbacteriosis goes away by itself. If the symptoms continue to bother, the person is not cured. In such a situation, it is pointless to continue the fight against dysbiosis - you need to look for the root cause.
Western doctors never give their patients such a diagnosis. AT Russian healthcare dysbacteriosis is mentioned in a document called "Standards (protocols) for the diagnosis and treatment of diseases of the digestive system", approved by order of the Ministry of Health of the Russian Federation No. 125 dated April 17, 1998. But even here it does not appear as an independent disease, but only in connection with other intestinal diseases .
Surely, when you took a blood test, you heard such terms as “increased leukocytosis”, “increased ESR”, “anemia”. Dysbacteriosis is something similar. This is a microbiological concept, one of the manifestations of the disease, but not the disease itself.

How is intestinal dysbacteriosis indicated in the ICD?

International classification diseases(ICD) - a document that lists all possible diseases person, each assigned its own code. In the ICD, there is no such thing as dysbacteriosis. A doctor who establishes such a diagnosis for a patient finds himself in a difficult situation - after all, he must indicate in medical records the code.
Most often, such doctors use two codes: .
Sometimes dysbacteriosis is a temporary condition, for example, in travelers, especially if they have poor personal hygiene. A "foreign" microflora enters the intestines, which a person does not encounter at home.

Which doctor treats intestinal dysbacteriosis?

Since dysbacteriosis is not an independent disease, it is necessary to look for the initial cause, and then begin treatment with an appropriate specialist.
Most often, diseases that lead to a violation of the composition of the intestinal microflora should be treated by an infectious disease specialist or a gastroenterologist. A therapist treats a number of diseases in adults, and a pediatrician in children.

What is the best treatment for intestinal dysbiosis?

Since such a diagnosis does not exist, then “treatment of dysbacteriosis” is a term, in principle, meaningless.
Although, the relevant recommendations still exist - they are spelled out in the standard OST 91500.11.0004-2003. It was put into effect by the Order of the Ministry of Health of the Russian Federation of 06/09/2003 N 231. This document proposes to treat dysbacteriosis with the help of prebiotics and eubiotics, antibacterial and antifungal drugs.
But the effectiveness of these medicines with dysbacteriosis has not been proven. In the same OST there is such a phrase: “the degree of persuasiveness of evidence is C”. This means that sufficient evidence is missing. There is no evidence to recommend treatment of dysbacteriosis with these drugs.
Here it is once again appropriate to recall that doctors who work in clinics outside the CIS never make such a diagnosis to their patients, and even more so they do not prescribe treatment against dysbacteriosis.

Is there a link between intestinal dysbacteriosis and thrush?

Thrush, or candidiasis- a disease that causes yeast-like fungi kind Candida.
The infection can develop in any organ. In this regard, candidiasis of the skin and nails, the oral mucosa (just this form is called thrush), intestines, and genital organs are isolated. The most severe form of the disease is generalized candidiasis, or candidal sepsis when the fungus affects the skin, mucous membranes, internal organs.
candida - fungus conditionally pathogenic. They are not always able to cause infection, but only under certain conditions. One of these conditions is a decrease in immunity. Thrush may well be combined with intestinal damage, which leads to dysbacteriosis. In fact, there is a connection between these two states.
In this case, the same reasons lead to the development of thrush and intestinal dysbacteriosis - a decrease in immunity and a fungal infection. They need to be treated.

Is it possible to use folk remedies for the treatment of intestinal dysbacteriosis?

Traditional medicine, if proven remedies are used correctly, can improve the condition and alleviate the symptoms of the disease. But it can only be used as an addition to the main treatment prescribed by the doctor.
Due to the fact that the topic is inflated and very popular, "anti-dysbacteriosis remedies" are offered by all kinds of traditional healers, healers, manufacturers of dietary supplements, MLM companies. Food producers did not stand aside either.
As already mentioned above, dysbacteriosis as a disease does not exist, it does not have its own specific symptoms, and it cannot be cured without eliminating the root cause. Therefore, first of all, you need to visit a doctor, undergo an examination, establish the correct diagnosis and begin treatment.

What can an analysis for dysbacteriosis show?

The majority of reputable doctors and scientists deeply doubt the information content of the microbiological analysis of feces for dysbacteriosis. There are certain reasons for this:

• The concept of " normal microflora' is very blurry. Nobody knows the exact rules. Therefore, if you force anyone healthy person pass the analysis, many will be "revealed" dysbacteriosis.
• The content of bacteria in feces is different from their content in the intestines.
• While the stool is delivered to the laboratory, the composition of the bacteria that are present in it may change. Especially if it is incorrectly assembled into a non-sterile container.
• The composition of the microflora in the human intestine can vary depending on different conditions. Even if you take the analysis at different times from the same healthy person, the results can vary greatly.